The primary purpose of this research is to test the effectiveness of alcohol abuse prevention strategies targeting high-risk youth in a primary health care setting. These prevention strategies will be based on an innovative Multi-Component Motivational Stages (McMOS) theoretical model. Specifically, we propose to evaluate the efficacy of a three- component prevention intervention titled the STARS program (Start Taking Alcohol Risks Seriously). This intervention will involve: 1) youth Self- Instructional Modules and corresponding audio-tapes; 2) brief Health Consultations provided by physicians and nurses; and 3) [six Extended Follow-Up Consultations provided by nurses.] This study will employ an experimental design to test the effects of the proposed primary health care intervention. This study is designed to examine replicable, health care-based prevention strategies. The primary outcome measures to be examined include alcohol consumption patterns, and the stages of alcohol use acquisition and change. Secondary, mediating outcome measures will include the use of other drugs including cigarettes, smokeless tobacco, marijuana and cocaine; frequency of use of self-control strategies for avoiding alcohol consumption; cognitive and social factors including expectancy beliefs, self-efficacy, influenceability perceived prevalence of use, and intentions to use; and alcohol-related health beliefs and motivation to avoid alcohol use. Short-term (3 months), mid-term (1 year) and long-term (2 year) outcomes will be determined for the prevention strategies. Longitudinal studies such as the one proposed are much needed in the area of youth alcohol abuse prevention (Coodstadt, 1986; Hansen, 1992; Moskowitz, 1989). The proposed two year follow-up will provide invaluable information regarding the potential long-term sustained effects of the intervention components, and the temporal role of various causative factors in the movement of youth through the stages of alcohol use acquisition and change.